“…Unfortunately, in addition to experiencing a health disadvantage compared to whites, AI/ANs often have lower socioeconomic status than whites, which negatively influences health outcomes (Huyser et al, 2010;Link & Phelan, 1995). American Indian and Alaska Native peoples tend to have lower levels of education and income, have lower returns on education (Gregory et al, 1997;Sandefur & Liebler, 1997;Snipp, 1986;1989;Snipp & Sandefur, 1988), and have higher rates of poverty relative to comparable whites (Huyser et al, 2014). Furthermore, AI/AN households that live near tribal lands are more likely to have lower educational attainment, higher poverty rates, a greater prevalence of femaleheaded households, and higher fertility rates than AI/AN households that reside in metropolitan areas with no tribal lands (Liebler, 2004;Sandefur & Liebler, 1997;Snipp, 1989).…”